Changing !!

[Shaz White]

I had an appointment today with my Diabetes Team and as my BG Levels are continuing to rise they have decided I should change from 2 injections (Humulin M3) to Nova rapid 4 times a day, got to wait for appointment to come through to see the Nurses so they can explain everything, is this a good thing to be doing? How long does it take to work out the Carbs etc it sounds really complicated!! My Hba1c was 77!! (not sure on the %) so have got to do something. All you experts out their can you give me some hope, advise or help!!😱

 

[Mark T]

...My Hba1c was 77!! (not sure on the %) so have got to do something. All you experts out their can you give me some hope, advise or help!!😱

From the HbA1c link at the top of the screen 77 == 9.2%

I'll let someone else comment on the basal/bolus regime - but I believe it's much more flexible then mixed insulins.

 

[Lauras87]

I had an appointment today with my Diabetes Team and as my BG Levels are continuing to rise they have decided I should change from 2 injections (Humulin M3) to Nova rapid 4 times a day, got to wait for appointment to come through to see the Nurses so they can explain everything, is this a good thing to be doing? How long does it take to work out the Carbs etc it sounds really complicated!! My Hba1c was 77!! (not sure on the %) so have got to do something. All you experts out their can you give me some hope, advise or help!!😱

I'm on novo rapid 3 times a day & it's better than the 2 injections a day system as there is no snacking needed, it's flexible etc.
I was started on 2 injections a day & I found them hard til I got switched over to novo rapid & glargine. Are you having a back ground insulin too?

 

[Copepod]

A system of short acting insulin (one per meal) and long acting (one or two injections per day) is also called MDI (multiple dose insulin) or basal bolus - I'm mentioning those terms so that you can search for other threads, if you like.

It's far more flexible, both in terms of what you can eat and when you can eat. Basically, you match dose to food / activity etc, insead of matching food etc to dose. So, generally, you need slightly less insulin and food overall.

Anyway, the nurses should be able to explain more in person.

 

[DeusXM]

It's worth remembering that flexibility is a double-edged sword. It means that you have far more control over your blood sugar - but it also means you therefore have to take control of them too.

The good news is, it isn't too complicated. The first few weeks are the hardest because you need to get to grips with the idea of how much insulin you need for each item of food. But once you've had a bit of practice, you can get quite good at eyeballing food and working out how much you'll need.

The reality of things is fairly simple. The majority of things you eat will contain nutritional information - you need to use this to work out how big your portion is, and therefore how many carbs are on your plate. You then need to divide this by your insulin ratio, which your care team should provisionally work out for you.

So an example could be, say you're eating a bowl of shredded wheat. The nutritional information suggests there are 40g of carbs in it. Your care team has told you your insulin ration is 1u per 10g of carbs. So you divide 40 by 10 - 4u of bolus insulin.

That's the basic premise behind everything - it might seem like a lot of work at first but this stuff becomes second nature and you'll find you have fewer highs, fewer lows and better A1cs as a result.

 

[Shaz White]

Changing!!

Hey thanks all for your replies it sounds like I will have my work cut out for me but hopefully it will be worth it in the long run. I will be having a background long acting insulin as well but dont know what its called yet, does anyone know of the weight issues with either of these insulin regimes, as I have been putting weight on with my 2 injections and I just wondered if it is easier to keep your weight steady when having the nova rapid 4 times a day?

 

[megga]

You should have better control of your weight, as mentioned you only need to bolus for the food you eat, you wont need to eat for the insulin, so you can eat better.
You can buy nutrional scales (Avon do them and you can get them from ebay for around ?10) these help alot when starting on 4 injections a day as you can put you fod on EG pataoes, put the code in and it will tell you how many carbs are in it.

 

[DeusXM]

I just wondered if it is easier to keep your weight steady when having the nova rapid 4 times a day?

Yes and no.

On your mix insulin doses, you have to eat set amounts at set times - regardless of whether or not your body actually needs the energy.

Therefore, used sensibly, you only have to eat when you actually need to, so you are less likely to put on weight. You can also make smarter dietary choices. Body fat primarily comes from increased blood sugar converted to fat by insulin. So you can make dietary choices that do not increase blood sugar, meaning there's little to nothing to convert to fat. You can also as a result take less insulin (insulin inhibits fat metabolism) but still keep your blood sugar under control. You also have the flexibility to scale back insulin doses so you can exercise and avoid hypos at the same time.

However...while you can make smarter dietary choices, you can also more easily get away with bad ones on MDI. Because you cover what you eat with insulin, it becomes a lot easier to eat foods that are both high in carbs and high in fat. For instance, eating a whole pizza on MDI is easier than eating on whole pizza on mix. It can be easy to fall into the trap where you assume because your blood sugars are fine, you don't need to worry about what you're eating. All MDI does is make you pretty much the same as someone without diabetes. Most non-Ds wouldn't eat junk food all the time even though their blood sugar will be fine, because it'll make them put on weight. It'll be the same for you.

So as with your blood sugar control, MDI simply gives you more flexibility to do things better - it's up to you whether you do or not!